Inhibit cell wall synthesis Flashcards
Mode of resistance to lactams
Penicillinases (beta lactamases), PBP structure changes, change in porin structure (mainly for gram -)
MOA of lactams
Bind PBP, inhibit transpeptidation (cross linking) of cell wall
Classes that are lactams
Penicillins, cephalosporins, methicillins,
Major use for penicillin V and G
Syphillis
Major target of the methicillin, nafcillin, oxacillins
Non mrsa staph aureus
Beta lactamase resistant lactams
Methicillin, nafcillin, oxacillins
Drug for mrsa
Vancomycin
Targets for amoxicillin and ampicillin
Gram + cocci other than staph, listeria, gram -, e. Coli, h. Flu, h, pylori, borrelia
Ticarcillin, pipercillin, azlocillin targets
Mainly for pseudomonas but also extended from amoxicillin
Tocarcillin, pipercillin, azlocillin can be given which way
IV in hospital
Beta lactamase inhibitors
Clavulonic acid and sulbactam and tazobactam
Which group of Antibiotics are synergistic with penicillins?
Aminoglycosides
All in this wall syn group inhibitors are all nephrotoxic except
Nafcillin, oxacillin they use bile excretion
First generation cephalosporins
Cefazolin, cephalexin
First generation cephalosporins targets
Gram +, some gram -, was used for surgical prophylaxis
Second generation cephalosporins
Cefotetan, cefaclor, cefuroxime
Second generation cephalosporins targets
Better gram negative coverage, and cefuroxime can cross blood brain barrier
Third generation cephalosporins targets
Broad spectrum, used in empirical management of sepsis and meningitis, NO activity against listeria, atypical pneumonias, MRSA, enterococcus think LAME
Fourth generation cephalosporins
Cefepime, which is used IV and is beta lactam resistant
Third generation cephalosporins
Ceftriaxone, cefotaxime, cefdinir, cefixime
Cephalosporins not excreted thru kidney
Cefoperazone (lipid soluble but cannot get thru blood brain barrier) and ceftriaxone
What class is good to use of there is allergy to penicillin/cephalosporins
Macrolides or aztreozam(only if gram - rod)
Unique cephalosporins SE
disulfiram like effect mainly by Cefoperazone
Imipenem and meropenem MOA
same as penicillin and cephalosporin…are also beta lactamase resistant
Imipenem and meropenem used for
Gram + cocci, gram - rods; in hospital use empirically for severe life threatening infections (nosocomial) l; can’t work on MRSA
Imipenem must be given with
Cilastatin, it is a renal dihydropeptidase inhibitor to slow metabolism
Imipenem somewhat unique SE is
Seizures
Aztreozam use
Beta lactamase resistant, only for gram - rods, MOA is like others
Vancomycin MOA
bind to D ala D ala muramyl pentapeptide that then stops transglycosylation
Vanco uses
Mrsa, C. diff, enterococcus
MOA OF resistance for vanco
D ala D lactate changes…this target changes
SE of vanco
Red man syndrome, ototoxocity, nephrotoxicity